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GO Online: Inspection toolkit

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Safe and effective staffing

Safe recruitment practices and staffing levels are fundamental parts of delivering good and outstanding care.

The following film provides a summary of this area of inspection. It can help you and your teams learn about what will be inspected and what is important to demonstrate to deliver good or outstanding care.

Introducing Safe and effective staffing

Duration 02 min 20 sec

Safe and effective staffing is reliant on having enough capable and confident staff to respond to the needs of the people you support.

The CQC inspection focus looks at staffing levels, recruitment practice and how you induct and develop your staff to deliver safe care. It is essential that your service has the right skills mix to meet the care needs of the people you support.

Because poor recruitment practice is a huge risk to your ability to deliver Safe care, the CQC will want to ensure you have robust checks for new staff, including DBS, the following up of references, and checking any previous training.

New staff should be appointed if they have the right values to work in care. Your induction process should provide staff with the opportunity to receive the knowledge, training, and the support they need.

For those staff joining the profession for the first time, ensure that the minimum induction standards are met, including workplace assessment of competence.

More experienced staff should have their learning periodically refreshed. Staff training and assessment should always go beyond the minimum, ideally helping to create subject matter experts or champions. Qualifications and apprenticeships are great ways to build expertise in your service.

Regular supervisions should be provided to all staff regardless of their length of service.

Workforce planning will require your service to people’s changing needs, absences, and other staff rota related issues. Rota systems can help but ensure your managers and staff are trained to use them.

In homecare and community-based services, ensure visits are planned to allow time for all care needs to be met. Contingency plans to maintain service provision will always need to be in place.

In addition to interview and potential observations, inspectors may choose to look at your Dependency tools and a range of documents including:

  • staff rotas
  • staff support, supervision, and disciplinary records
  • staff recruitment and employment records
  • and staff training and induction records, including qualifications.

GO Online brings together recommendations, examples, and resources to help you to recruit and safely staff your service.

Watch the film here:

 

Recommendations

These recommendations act as a checklist to what the CQC will be looking for. Â鶹ԭ´´ has reviewed hundreds of inspection reports and identified these recommendations as recurring good practice in providers that meet CQC expectations.

The CQC is non-prescriptive, which means they don’t tell you what must be done in order to meet their Quality Statement. These recommendations are not intended to be a definitive list and some recommendations might not be relevant to your service. We hope they help you reflect on what evidence you might wish to share with the CQC.

This covers two lists of recommendations related to workforce planning, induction, training and supervision of your staff team.

Workforce planning and recruitment

  • We can evidence that we provide safe staffing levels at all times.
  • We ensure our staffing levels are based on the needs of people who need care and support, as set out in their care plans.
  • We use staff matching tools to ensure new workers can appropriately meet the needs of the people they’ll be caring for.
  • We use workforce planning tools to ensure they have the right skills mix and numbers of staff to deliver the care and support needed. We schedule and communicate rotas at the earliest opportunity.
  • We’ve developed effective contingency plans to ensure we can maintain safe staffing levels, even if impacted by other factors (sickness, winter demands etc.).
  • We avoid an over-reliance on the use of temporary workers. Where recruitment agencies are used, we ensure their safety related checks are as robust as our own service.
  • We use values-based recruitment processes to recruit people with the right behaviours and attitudes to meet the standards of care we need.
  • We apply a robust approach to vetting new members of staff, reducing the risk of an unsuitable person being employed (e.g., we follow up personal and professional references, look into their training records, focus on gaps in employment history and check how they’d respond to certain scenarios).
  • We involve more than one person in the selection process when recruiting more staff. Where practical, we involve people and families we support in the recruitment process (e.g., giving them the chance to contribute to the job description, choose interview questions, be part of the interview panel and be consulted before new workers are selected, etc).
  • When we interview for a senior member of the team, we will seek an external representative to be on the interview panel.
  • We obtain Disclosure and Barring Service (DBS) and other identity checks (including rights to work in the UK) prior to the new staff member start date. Where possible, we ensure a minimum of two references are followed up and all checks are thorough and well documented.
  • If we employ nurses, we check to confirm qualified nursing staff are correctly registered with the Nursing and Midwifery Council (NMC) and are also held on file. Where appropriate to the role, we check that revalidation has been completed.
  • We ensure staff records contain all the information required under Schedule 3 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
  • We ensure those joining the organisation are keen to undertake training and actively learn new skills.
  • We ensure our staff have or are supported to achieve the core skills essential to enable them to support people, other staff, and those they engage with. This includes being able to clearly communicate with individuals, as well as digital, writing and number skills.
  • We use probation periods of at least three months so we can assure ourselves that new staff are right for the organisation and can deliver the quality of care needed.
  • We’ll only continue to employ staff if their values and performance meets the needs of the people we support.
  • We ensure staff safety is as important as the safety we put in place to protect the people we support.
  • Where relevant to our service, we ensure travel time has been effectively considered and that it doesn’t impact on the amount of time spent providing the care needed.
  • Where relevant to our service, we notify people who need care and support in advance if there’s a change of care worker or that the visit time has changed. We aim to keep such changes to a minimum.
  • Where relevant to our service, we plan there are enough staff to always visit people as scheduled.
  • We ensure good and timely communications are shared with the people we support, and family should we have a short-term issue leading to any delay in provision.

Training, supervision, and support

  • We can evidence the training, support and supervisions undertaken by our managers and staff.
  • Our training ensures our staff are capable and confident to deliver safe care. We ensure staff are capable and confident on all safety related training including fire safety, health and safety, assisting and moving, basic life support, etc.
  • Our induction programme provides an effective introduction to our service. We ensure all staff understand our policies and procedures as part of their induction.
  • Our induction programme and associated training has been developed and/or delivered using input from the people we support.
  • We ensure new staff are supported by assigning a mentor, buddy or similar role. This provides our new starters with a trusted colleague to turn to during their induction period (and potentially beyond).
  • We ensure staff are shadowed and supervised up until they’re both confident and assessed as competent to work alone.
  • We regularly check the competence of our new and existing staff. We challenge poor practice and arrange additional training and support where required.
  • We performance manage situations where further training and support does not result in better care. Where this is necessary, we keep clear records of the process and any disciplinary actions.
  • We ensure that our training – whether internally developed and delivered or commissioned in – is of a high quality.
  • We ensure our training is flexible to meet different learning styles.
  • We ensure our staff training is regularly reviewed and refreshed in line with legislation and national good practice recommendations.
  • We ensure our refresher training is a meaningful activity and not a tick-box exercise.
  • We support our staff to set their own goals as part of the appraisal process.
  • We ensure all staff involved in the preparation or distribution of food and drink receive training and refresh this in line with good practice.
  • We support our staff to develop themselves beyond induction, providing opportunities for additional training that deepens knowledge and competence.
  • Where qualifications are needed for a specific role, we will support staff to achieve these.
  • We actively encourage our staff to expand and develop in areas that they are interested in.
  • We actively support succession planning that provides opportunities for internal talent to develop into more senior roles and potentially future managers.
  • We keep detailed records of staff training and know what courses, qualifications, and other learning has been undertaken.
  • All staff receive regular supervisions which provide an opportunity to discuss their support needs and learning.
  • We ensure our staff support is not just limited to formal meetings and that each staff member can contact us for assistance when they need to.
  • We review the reasons why staff leave and invest time and resource in identifying areas for improvement.

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